Nicole Elizabeth Peters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007118 Issued in GA

Practice address

771 Old Norcross Rd
Suites 155 and 390
Lawrenceville, GA 30046-4386

Phone

(770) 682-6000

Fax

(770) 513-1103

NPI assigned

Apr 14, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Nicole Elizabeth Dykes Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peachtree Orthopaedic Clinic PAGroup PAC ID 4587552963, 138 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.9 of 100Reported as group

Promoting interoperability

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicole.peters.1@8474.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peachtree Orthopaedic Clinic PA

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1811912611
  Medicare reassignment Care Compare group NPD (past)
• Peachtree Orthopaedic Clinic

  • Durable Medical Equipment & Medical Supplies
  • Alpharetta, GA
  • NPI 1588802474
  NPD
• Peachtree Orthopaedic Clinic, P.a.

  dba Peachtree Orthopaedic Physical Therapy

  • Physical Therapist
  • College Park, GA
  • NPI 1497781942
  NPD
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Aiken, SC
  • NPI 1427887157
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1710306188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE",
            "address_2": "SUITE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393035",
            "telephone_number": "770-953-6929",
            "fax_number": "770-953-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "address_2": "SUITES 155 AND 390",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "770-682-6000",
            "fax_number": "770-513-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DYKES",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pet Imaging Center of Gwinnett LLC (Trident Medical Imaging- Gwinnett)
• Dawn Marie Peters, NCMT
• Jessica Rogers Peters
• Joslyn Peters
• Micayla Anne Peters
• Marsh Peterson
• Seth William Peterson
• Loritz Petit-Homme
• Richard G Petit, P.A.
• Mary Petner, LMSW

• Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.